The population ageing is an universal problem concerning all countries in the world, not only in Europe. The main sources of this process are decreasing fertility and increasing life expectancy. The migration has additional impact on ageing in some countries. The ageing of population means many new challenges in the field of economy and society. The quality of life of older people and the entire  population as well depends on how countries will meet these challenges and how societies will adapt to the changing demographic conditions. Longer life can mean activity, health and participation, but it depends on properly planned activities in many areas of social and economic life. The phenomenon of ageing and the consequences associated with them are extremely complex and multilateral issues. The presented article focuses on the comparision of the process of ageing in different continents and countries, particularly in Poland. It concerns the problem of the ageing impact on labour market and health care sector as well.

Chronic diseases are main reason of death in most of the countries around the world. Because of their nature and etiology the risk of chronic disease increases with age. Ageing of populations caused by low birth rate and increase of life expectancy have also impact on the increase of the prevalence of chronic diseases. Despite of mortality, chronic diseases are a reason of disability and low quality of life. Chronic diseases have also economic effects, influence current economy and future growth. Fortunately, many of the risk factors for chronic disease are known and can be prevented. All of mentioned aspects of chronic diseases were reason for development of the strategy of “healthy ageing” meaning, “helping people to live long and productive lives and enjoy a good quality of life”.

The ability to function independently is crucial for successful aging, while an age through the development of involutional changes and risk of comorbidity promotes functional limitations. On average, 20% of people over 70 years of age need help in at least one of the 6 basic activities of daily living. The ability to cope in everyday life is affected by the reduction of physical fitness, sensory impairment and the effects of chronic conditions, falls and injuries. Deterioration of physical fitness is a consequence of muscle mass and strength reduction, impaired neuromuscular function resulted in slowing nerve conduction and reaction time, deterioration of balance, coordination and central transmission. Vision and hearing disorders are a consequence of aging and diseases. Cognition impairment, important for an independence, may be a consequence of degenerative changes in the CNS or dementia. Numerous studies have confirmed the relationship of involutional changes, accompanying diseases, falls and injures with limitations in daily functioning, and maintaining physical activity and implementation of a comprehensive geriatric assessment into geriatric care with an early diagnosis of deficits and implementation of intervention can prevent or delay the disclosure of disability.

In frame of the European Project CHANGE (Care of Health Advertising New Goals for Elderly people) the study of health behaviours regarding healthy nutrition and physical activity was conducted on patients in age of 60 and more covered with care of community nurses. Objectives: To assess association between physical activity and nutritional habits, stages of change of these behaviors among older patients and other psychosocial conditions regarding planning of health education intervention to change their health behaviours.

Methods: 108 persons at age avg. 69.6 (SD 60–87) were interviewed by questionnaire (assessing the frequency of intake of particular food products, physical activity, motivation and stage of change these behaviors, satisfaction with physical condition and general wellbeing) by the trained community nurses.

Results: Results showed sedentary style of life in most studied patients. Among physical activity the frequency of daily walking was the highest (69%), while 70% of older people did not exercise. In study group 42% were not aware of importance of physical activity for their health. But the awareness of importance of healthy nutrition was high, and about half of study group (48%) reported that they eat meals with reduced fat, and 80% eat high fiber food. The rules of healthy nutrition were not fully respected. Positive correlations were shown between intention to change, stage of change of health behavior and performance of physical activity and healthy eating. Those behaviors were positively related to well-being and satisfaction with physical condition.

Conclusions: Health promotion programs for older patients should be planned in different way depending on their stage of change of health behaviors. There is a need to raise awareness of importance of physical activity, and to educate older patients about recommended types of exercises and recreation. In case of recommendations of healthy nutrition, the awareness is high and performance definitely more frequent, therefore health promotion programs should stimulate development of permanent social support to maintain change of these behaviors.

The aim of this article is to explain the concept of silver economy and present two examples of its implementation into the strategy and regional development programmes in Europe: North Rhine-Westphalia and Małopolska region. The concept of silver economy is based on an assumption that population ageing is not exclusively the burden to the economy but it contributes to its new growth factors. However, it is conditioned by an increased activity of senior citizens in labour, consumption and social fields. Prolonged ability tolead an active life of good quality demands investment in the health of population in general, not only of senior citizens. Healthy ageing requires an early intervention process. In the strategy for Małopolska,(differently than in the case of North Rhine-Westphalia), health sector is plays an important role in the economyas a place of healthy ageing interventions carried out as part of chronic diseases preventions, health promotion, rehabilitation, geriatric medical care and long-term care. It is because of the potential generated by the medical labour resources and rehabilitationfacilities for health-oriented silver economy strategy prepared for Małopolska region.

The adverse consequences of an aging society for the stability of health care financing systems are superimposed on the natural inequality of the distribution of health needs, and consequently, expenditure for health services in the life cycle of man. How long, under such conditions, will financial security systems based on the mechanism of PAYG (pay as you go) be able to guarantee all of its citizens, including the oldest ones, broad access to medical care? The debate brought about by D. Callahan in 1987 on “age-based rationing of benefits” for many years focused on trying to find ethical and economic rationale for limiting the scope of benefits guaranteed to the oldest citizens (eg A.  illimas, F. Breyer, D. Brock, N. Daniels, P. Dabrock). Age-based benefit rationing from public funds, however, may soon become a reality if we do not manage to break ties, within the public system, with the idea of full socialization of the costs of old age at the expense of future generations. Maintaining fundamental fairness towards the future generations requires an equal sharing of the financial consequences of aging, and this means taking on more responsibility of every individual for himself. A good practice of substitute private health insurance in Germany is the mandatory creation of individual financial reserves for old age which allows avoiding an excessive rise of equivalent risk premium in old age. Another solution for social health insurance might be reserves built by each generation, or a general public reserve. The transition from the purely PAYG system to a more capital one, however, will require the construction of functional solutions for the transitional period in which we have yet to build reserves and fund services for older generations who have not yet built reserves for themselves. An apparent increase of the country’s debt seems therefore inevitable, but also present older generations must be held financially accountable through higher premiums or payments for benefits.

While population is aging we are facing raising number of geriatric problems. It is obvious nowadays that if we do not start creating certain plans considering medical and social care of elderly people, the situation may get out of control.
The natural course of diseases in elderly is different to middle aged and young people. These individuals show different symptoms and social background, different prognosis and complications of the disease and of diagnostic and therapeutic medical procedures themselves. The major feature that distinguishes geriatric medicine from others is comprehensive geriatric assessment which is holistic and considers not only medical condition but also social, psychological background together with identifying aspects of functional status, nutrition, transportation and others.
It seems that the need for professionals with experience in geriatrics is growing. The most important in this area are general practitioners and geriatricians. There is also a constant need for educational effort to create society whose members are responsible for their own health.

Background: It is thought that at least one medication is taken by up to 60% of elderly people. What is more, in US elderly people living in the community take on average four medications, while home-care residents take averagely seven drugs a day. The above-mentioned facts, in the light of current demographic changes of the structure of population, indicate the growing cost of ambulatory drug therapy of the elderly.

Aim of the study: To analyze the costs of one month of ambulatory drug therapy in the group of elderly aged 80 and over following hospital discharge. Moreover, the relation between the number of pills and drugs taken in general, concomitant illnesses and costs of therapy were assessed.

Materials and methods: The retrospective analysis of medical documentation of 116 patients aged 80 and over was performed. The costs of therapy were calculated accordingly to the prices published in The Drug Index. Co-morbid illnesses were classified accordingly to the International Classification of Diseases (ICD-10). Analysis in the age subgroups was performed.

Results: Mean age was 85.2 ± 4.2y-rs, group consisted of 62 women and 27 men; 27 patients were excluded from further analysis. Mean number of prescribed drugs was 7.6 ± 2.9 (min.–max.: 1–16), mean number of prescribed pills was 8.8 ± 4.3 (min.–max.: 0–23). Patients in the examined group suffered from 5.8 ± 2.0 chronic diseases averagely. Mean cost of one month of ambulatory drug therapy was 135.9 ± 95.7 PLN (min.–max.: 1,96–625,9 PLN). Significant relations between the costs of ambulatory drug therapy and the number of chronic diseases (r = 0.51, p < 0.0001) as well as the number of pills (r = 0.68, p < 0.001) and drugs (r = 0.74, p < 0.001) were observed. The differences in the subgroups were observed.

Conclusions: The high co-morbidity observed in the elderly results in the need for taking a great number of drugs and consequently causes high costs of ambulatory drug therapy. When planning ambulatory treatment, it is important to analyze the patients’ and their families’ financial situation, and when necessary provide economical support.

The results of initial literature review indicate that elderly persons are underrepresented in the clinical trials on which clinical recommendations are based. This gave stimulus to perform the ‘Increasing the PaRticipation of the ElDerly In Clinical Trials’ (PREDICT) project, financed by the EU within the FP7. The goal of the PREDICT was to study reasons why older people are excluded from clinical trials based on age-related criteria and development of the charter including recommendations to prevent their exclusion. The project gathered investigators from 11 institutions in 9 countries: Czech Republic, Israel, Italy, Lithuania, the Netherlands, Poland, Romania, Spain, and the UK. Within the scope of PREDICT, first, to assess the scope of the problem the systematic review of literature was performed, then the opinion shared by the health care professionals, ethicists, and representatives of pharmaceutical industry on the possible reasons of underrepresentation of old people in trials was examined, then finally the opinion of elderly patients and their caregivers were assessed. The analysis of gathered data enabled creation of PREDICT charter which contains recommendations aiming to increase the participation of elderly people in clinical trials

Rehabilitation of people with disabilities is a process aimed at enabling them to reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. WHO, in “World Report on Disability”, defines rehabilitation as a set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments. Lack of rehabilitation services creates a barrier to full inclusion and participation in all aspects of life.
The aim of this article was to present the nature of medical rehabilitation, in particular medical rehabilitation of elderly people. The basic definitions of medical rehabilitation and physiotherapy were also presented. The medical rehabilitation system in Poland, its organization and funding system was shown based on publications and statistical data of the Central Statistical Office (GUS) as well the access to medical rehabilitation services and selected medical procedures was assessed based on available data from National Health Fund (NFZ) and Ministry of Health (MZ).

The process of ageing of modern societies is the source of substantial challenges for social and health care systems. The growing number of elderly persons may be perceived both in terms of the burden but  also as an opportunity. On one hand, elderly population requires additional forms of care and support. On the other hand, older persons shape a market for various types of services and products supporting them in independent and secure life.
Ageing usually results in progressing limitations of the sensory and cognitive functions as well as mobility. Thus, elderly population is a target audience for products belonging to the domain of assistive technologies. This term origins from first regulations accepted in USA in 60. in XX century in relation to elderly persons. Nowadays, it is used as umbrella term for all tools and systems applied for maintaining or increasing functional capacities of the person with various types of disabilities. Assistive technologies cover whole spectrum of products differing both in term of technical sophistication and complexity. There are many classes of assistive technologies which could be used by elderly persons depending on functional limitations occurring in a specific person. The solutions available currently demonstrates high technical advancement and trend for coverage of diversified aspects of every day living. The progress in the domain of supportive tools for elderly persons resulted in the concept of ambient assisted living. The concept is based on the desire of developing friendly and attentive environment for elderly persons assuring them independent and comfortable living. Ambient assisted living integrates the use of advanced sensory and communication technologies integrated as „smart home” and telemonitoring systems used not only in medical but also social context.
The expectation of establishment of supporting environment of living for elderly persons is also inherently linked to growth of the Information Society and ongoing embedment of information and communication technologies in all aspects of life.

Do najistotniejszych przyczyn demograficznego starzenia się społeczeństw należy stopniowe wydłużanie się życia ludzkiego, spowodowane m.in. poprawą warunków egzystencji i podniesieniem jakości świadczeń zdrowotnych, oraz spadek dzietności. Jeszcze w 2007 roku, kiedy
rozpoczęto projekt PolSenior, liczba osób w grupie 65 lat i więcej wynosiła 5,1 mln, co stanowiło 13,5% ogółu ludności. Prognoza GUS zakłada, że do 2035 roku liczba ludności w tej grupie wieku zwiększy się w stosunku do 2007 roku o 3,2 mln, a jej udział w ogólnej liczbie ludności wyniesie 23,2%